Kelley Hedrick
Senior Strategic Advisor
Wake Forest
Summary
Senior Strategic Advisor with a clinical foundation and expertise in value-based care, specializing in translating complex cost and utilization data into senior executive-facing insights that inform strategic direction and accelerate ACO performance. Serves as both external-facing relationship owner and internal SME for multiple ACOs, leading provider engagement strategy and aligning cross-functional teams around program priorities. Supports value-based program management by identifying operational gaps, driving execution, and ensuring alignment with enterprise goals. Recognized for blending clinical fluency, data acumen, and contractual strategy to troubleshoot challenges, elevate outcomes, and advance organizational objectives.
Overview
20
20
years of professional experience
3
3
Certifications
Work History
Senior Strategic Advisor
Blue Cross and Blue Shield of NC
06.2023 - Current
- Senior member of Consulting and Solutions Team leading efforts to drive performance and support ACOs in a value-based program called Blue Premier.
- Analyze, synthesize, and extract strategic findings from raw cost and utilization claims data to identify ACO trends and improvement opportunities.
- Present data-driven findings and targeted recommendations to senior leaders, including C-suite executives, across all supported ACOs—among them the program’s largest and most complex participant, a leading industry aggregator.
- Lead workstreams, Joint Operations Committees (JOCs), and Executive Steering Committee (ESC) meetings, providing strategic oversight on cost of care, utilization, quality, and risk adjustment efforts.
- Strengthen performance across supported ACOs, contributing to financial payout growth including a 103% increase for the largest ACO in the most recent performance year and notable cost and quality improvements, among others.
- Serve as business owner and internal subject matter expert for supported ACOs, leading cross-functional teams to solve challenges, align efforts, and drive initiatives that advance strategic goals with measurable impact.
- Provide peer mentoring and guidance on data analytics tools, fostering collaborative idea generation and skill development among colleagues.
- Closely collaborate with program managers and prompt action when needed to ensure processes and tasks are executed.
- On an enterprise level, support behavioral health initiatives and goals as part of Consulting and Solutions team Vertical ownership.
- Interpret ACO contract terms to assess financial implications, guide strategic decisions, and ensure alignment with program goals.
Strategic Advisor
Blue Cross and Blue Shield of NC
08.2021 - 05.2023
- Successfully onboarded three new ACOs in the Blue Premier Program ensuring the implementation of key components.
- Developed and presented cost and utilization insights to ACOs and senior internal and external leaders.
- Led planning around two Covid-19 vaccination events.
- Supported enterprise Behavioral Health (BH) goals tied to ACOs. Contributed to successful transition away from external vendor for BH provider connection services. Supported efforts from RFP scoring through messaging provider organizations in Blue Premier VBC program.
Nurse Case Manager
Blue Cross and Blue Shield of NC
09.2018 - 08.2021
- Selected to join Transition of Care (TOC) team supporting highest-cost members with acute and complex conditions focused on improving experience, reducing readmissions, and curbing avoidable spending.
- Maintained consistently high member engagement rates, driving trust, adherence, and continuity across complex care journeys.
- Commercial case management representative selected from a pool of 82 employees for enterprise AI pilot leveraging AI-driven segmentation models and developing SOPs adopted across business units.
- Presented cases and collaborated in weekly interdisciplinary pilot meetings bridging clinical nuance, operational workflows, and strategic redesign.
- Managed pilot data tracking and goal alignment; contributed to platform enhancements and workflow improvements across teams.
- Pilot earned dual recognition: Excellence in Service Innovation from ISSIP and Innovator Award from Healthcare Innovation Group for AI-enabled readmission prediction.
- Forged strategic partnerships across case management teams, streamlining workflows and enhancing member engagement through targeted education and referral protocols.
Safety Specialist (Pharmacovigilance)
IQVIA
11.2017 - 03.2018
- Utilized Argus Safety 7.0 to monitor, document, and manage pharmacovigilance data, ensuring compliance with regulatory standards.
- Received, triaged, reviewed, and processed serious adverse event data from various sources on time, within budget, and according to quality guidance.
- Assessed lifecycle safety data to discern whether it was reportable; tracked cases and sent them to regulatory authorities, ethics committees, and institutional review boards.
- Performed serious adverse event data entry for tracking into safety database, coded relevant medical terminology, wrote descript narratives, generated queries pertinent to the case, performed quality control, assisted with reconciliation, facilitated case closure, coordinated translations, and ensured deliverables were sent to the customer within assigned deadlines.
Consultant Nurse
Pharmaceutical Product Development (PPD)
02.2017 - 11.2017
- Delivered high-quality outsourced medical and technical information to clients, ensuring clarity and accuracy while strictly adhering to SOPs.
- Responded to inquiries and resolved challenges for healthcare providers, consumers, and sales representatives, delivering timely and effective solutions.
- Specialized in diabetes products, troubleshooting devices to enhance patient safety and ensure product efficacy.
- Identified, documented, and reported adverse events and product complaints in compliance with regulatory standards.
- Consistently maintained high performance metrics in quality and efficiency. Invited by leadership to pursue management training but opted to transition into pharmacovigilance.
Oncology Nurse Navigator
Cancer Treatment Centers of America (CTCA)
06.2010 - 08.2014
- Used evidence-based knowledge to determine suitability of patients for outpatient evaluation.
- Functioned as advocate for patients and their family members.
- Collaborated closely with physicians to make certain all crucial testing was complete for each patient based upon specific cancer type and stage of illness.
- Assisted patients in understanding their diagnosis, treatment options, and available resources.
- Managed patient cases and helped facilitate any necessary referrals to interdisciplinary team.
- Specialized in lung cancer and sarcoma but worked closely with brain, breast, melanoma, and others.
- Provided guidance and education to the sales force.
Director of Admissions and Marketing
ManorCare Health Services
07.2007 - 05.2010
- Managed admissions and grew census through sales and leading business development.
- Promoted two times in 3 years. Started role in region’s smallest facility (63 beds) and ended in the region’s second largest (158 beds)
- Led efforts to reach 100% occupancy for the first time in building’s history (158 bed facility).
- Coordinated and hosted internal and external marketing events.
- Managed and trained admissions coordinator, patient advocate, and back-up admissions team.
- Planned and executed business development strategy securing relationships with physicians, hospital personnel, and community organizations.
- Used nursing skills to assess patients in other levels of care to determine needs once transferred.
- Educated families on benefits including Medicare, Medicaid, and Insurance.
Oncology Nurse
Advocate Lutheran General Hospital
11.2005 - 07.2007
- Evaluated, planned, implemented, and documented nursing care for acute oncology population.
- Administered chemotherapy and biotherapy.
- Provided supportive care such as pain management and wound care.
- Cared for bone marrow transplant patients.
- Helped patients and families confront end of life issues.
- Assisted physicians with procedures, problem solving, documentation, and assessment.
Education
MSN - Nursing and Healthcare Leadership
Duke University
BSN, Accelerated Program - undefined
Research College of Nursing – Rockhurst University
BGS, Double Major - Communications and Psychology
University of Kansas
Semester Study Abroad - undefined
Consortium International University
Skills
- Strategic Planning
- Data Analysis
- Value Based Care
- Excel (Advanced)
- Executive Presentations
- Cross Functional Leadership
Certification
North Carolina registered nurse (compact state), 285573
Timeline
Senior Strategic Advisor
Blue Cross and Blue Shield of NC
06.2023 - Current
Strategic Advisor
Blue Cross and Blue Shield of NC
08.2021 - 05.2023
Nurse Case Manager
Blue Cross and Blue Shield of NC
09.2018 - 08.2021
Safety Specialist (Pharmacovigilance)
IQVIA
11.2017 - 03.2018
Consultant Nurse
Pharmaceutical Product Development (PPD)
02.2017 - 11.2017
Oncology Nurse Navigator
Cancer Treatment Centers of America (CTCA)
06.2010 - 08.2014
Director of Admissions and Marketing
ManorCare Health Services
07.2007 - 05.2010
Oncology Nurse
Advocate Lutheran General Hospital
11.2005 - 07.2007
BSN, Accelerated Program - undefined
Research College of Nursing – Rockhurst University
BGS, Double Major - Communications and Psychology
University of Kansas
Semester Study Abroad - undefined
Consortium International University
MSN - Nursing and Healthcare Leadership
Duke University